| NPI | 1013976505 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOWARD J. HEIZE Physician 803-865-6008 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: SC 19871) |
| Enumeration Date | 2006-03-22 |
| Last Update Date | 2020-08-22 |